PHTLS Post Test 9th Edition (Latest 2023/ 2024) Questions and Verified Answers| Grade A, Exams of Nursing

Download PHTLS Post Test 9th Edition (Latest 2023/ 2024) Questions and Verified Answers| Grade A and more Exams Nursing in PDF only on Docsity! PHTLS Post Test 9th Edition (Latest 2023/ 2024) Questions and Verified Answers| Grade A QUESTION A trauma patient who has fallen 20 feet from an apartment balcony is alert with warm, dry, pink skin, with normal capillary refilling time to the lower extremities, and is hypotensive. The upper extremities are cool, pale and diaphoretic. Which of the following injuries should be suspected? A. Aortic dissection B. Liver laceration C. Fractured pelvis D. Spinal cord injury Answer: D. Spinal cord injury QUESTION Which of the following is a limitation of prehospital fluid resuscitation of the patient in hemorrhagic shock? A. Inability of fluids to carry oxygen B. Pulmonary edema C. Increased hemorrhage D. All of the above Answer: D. All of the above QUESTION Which of the following statements regarding signs of intraabdominal injury is NOT true? A. Fresh blood in the abdominal cavity does not cause signs of peritonitis B. A significant amount of blood loss occurs before abdominal distention can be noticed C. Substantial intraabdominal hemorrhage always causes tenderness and abdominal rigidity D. Signs and symptoms of shock greater than can be explained by other injuries is a reliable indicator of intraabdominal injury Answer: C. Substantial intraabdominal hemorrhage always causes tenderness and abdominal rigidity QUESTION Which of the following assessment techniques is least useful in the prehospital assessment of the patient with suspected intraabdominal trauma? A. Palpation B. Auscultation C. Inspection D. Scene assessment Answer: B. Auscultation QUESTION Pregnant trauma patients should be placed on the left side because: A. This prevents seizures due to eclampsia B. This prevents abruption of the placenta C. This prevents compression of the vena cava D. This is the best way to auscultate fetal heart tones Answer: C. This prevents compression of the vena cava QUESTION Survival of the fetus in a trauma situation is most dependent upon which of the following factors? A. Gestational age of the fetus B. Prenatal care C. Immediate cesarean section B. Pelvic fractures C. Femur fractures D. All of the above Answer: C. Femur fractures QUESTION Which of the following descriptions meets the criteria for transport to a facility with a burn unit? A. A 49 year old female with a partial thickness burn from her elbow to her shoulder B. A 25 year old male with an electrical burn across his chest C. A 9 year old make with superficial burns on the backs of both legs D. A 32 year old female with a partial thickness burn about twice the size of her hand on her back Answer: B. A 25 year old male with an electrical burn across his chest QUESTION The preferred method of dressing burns in the prehospital setting is: A. Dry sterile dressing B. Moist sterile dressing C. Wet dressings D. Petroleum gauze Answer: A. Dry sterile dressing QUESTION In assessing the hypothermic patient in the prehospital setting, the most reliable indicator of the severity of hypothermia is: A. Rectal temperature B. Oral temperature C. Heart rate < 60 D. Presence or absence of shivering Answer: A. Rectal temperature QUESTION In the normal child, which general statement is most accurate in comparison with the adult patient? A. Blood pressure is higher, hear rate is higher, and ventilatory rate is higher B. Blood pressure is lower, heart rate is lower, and ventilatory rate is higher C. Blood pressure is lower, heart rate is higher, and ventilatory rate is higher D. Blood pressure is lower, heart rate is higher, and ventilatory rate is lowe Answer: C. Blood pressure is lower, heart rate is higher, and ventilatory rate is higher QUESTION A patient who withdraws from painful stimuli, opens eyes on verbal command, and cannot speak because of intubation has a Glasgow Coma Scale of which of the following: A. 8 B. 8T C. 7 D. 7T Answer: B. 8T (E-3, V-T, M-4) QUESTION The earliest site for intraosseous infusion is: A. Anterior tibia, just above the tibial tuberosity B. Anterior fibula C. Anterior tibia, just below the tibial tuberosity D. Posterior fibula Answer: C. Anterior tibia, just below the tibial tuberosity QUESTION Which of the following behaviors is the most reliable indication of confusion in the elderly trauma patient? A. Inability to recall his/her name B. Inability to recall the day of the week C. Inability to identify his/her present location when out of his/her normal residence D. Focus on repeated retelling of events that occurred years ago Answer: A. Inability to recall his/her name QUESTION In the elderly trauma patient a high index of suspicion for shock should occur beginning when the systolic blood pressure is less than: A. 90 mmHg B. 150 mmHg C. 120 mmHg D. 100 mmHg Answer: C. 120 mmHg QUESTION In an adult patient, blood loss into the tissue from a fractured femur may be as much as which of the following? A. 150 to 500 mL B. 500 to 1000 mL Answer: C. The ability to quickly locate and manage life-threatening and potentially life-threatening injuries QUESTION You arrive at the scene of a motor vehicle collision in which a vehicle struck a tree. Which is the best indicator of potential injury? A. Circumference of the vehicle B. Diameter of the tree C. Mass of the vehicle D. Speed of the vehicle Answer: D. Speed of the vehicle QUESTION The potential for death or serious injury is greatest in which of the following motor vehicle collisions? A) Down and under B) Ejection from vehicle C) Lateral compression D) Up and over Answer: B) Ejection from vehicle QUESTION Which of the following represents adequate spontaneous ventilation in an adult? A. Tidal volume 100 mL, ventilatory rate 40/minute B. Tidal volume 500 mL, ventilatory rate 8/minute C. Tidal volume 300 mL, ventilatory rate 16/minute D. Tidal volume 600 mL, ventilatory rate 12/minute Answer: D. Tidal volume 600 mL, ventilatory rate 12/minute QUESTION Which of the following is 100% accurate in verifying endotracheal tube placement? A. Pulse oximetry B. End-tidal capnometry C. Syringe aspiration D. None of the above Answer: D. None of the above QUESTION When utilizing percutaneous transtracheal ventilation, the correct ration of lung inflation to lung inflation time, in seconds, is: A. 1:4 B. 1:5 C. 1:2 D. 2:2 Answer: A. 1:4 QUESTION Which of the following is a possible complication of using a manually triggered oxygen powered device for ventilation? A. Gastric distention B. Pneumothorax C. Inability to feel lung compliance D. All of the above Answer: D. All of the above QUESTION Which of the following procedures is considered an essential airway skill? A. Needle cricothyroidotomy B. Endotracheal intubation C. Insertion of an oropharyngeal airway D. Retrograde endotracheal intubation Answer: C. Insertion of an oropharyngeal airway QUESTION Pericardial tamponade is most likely to occur in which of the following situations? A. Stab wound to the chest B. Fall from a height C. Frontal impact vehicle crash D. Gunshot wound to the chest Answer: A. Stab wound to the chest QUESTION Which of the following is the preferred site for needle decompression of a tension pneumothorax? A. 4th intercostal space, midclavicular line, just over the top of the 5th rib B. 4th intercostal space, midclavicular line, just below the 4th rib C. 2nd intercostal space, midclavicular line, just over top of the 3rd rib D. 2nd intercostal space, midclavicular line, just below the 2nd rib Answer: C. 2nd intercostal space, midclavicular line, just over top of the 3rd rib Answer: A. Systemic acidosis QUESTION Bilateral femur fractures are most often associated with which type of motorcycle crash? A) Angular impact B) Bike-road impact C) Head-on impact D) Rear impact Answer: C) Head-on impact QUESTION Which is the preferred fluid for resuscitation of hemorrhagic shock in the prehospital setting? A) 5% dextrose in water B) 7.5% hypertonic saline C) Hetastarch D) Lactated Ringer's Answer: D) Lactated Ringer's QUESTION Which is the most common cause of upper airway obstruction in the trauma patient? A) Blood B) Teeth C) Tongue D) Vomitus Answer: C) Tongue QUESTION Which is the preferred adjunct device for verifying placement of an endotracheal tube in a patient with a perfusing rhythm? A) End-tidal CO2 monitoring (capnography) B) Esophageal detector device C) Pulse oximeter D) Stethoscope Answer: A) End-tidal CO2 monitoring (capnography) QUESTION Which is the most important reason to maintain an open airway in the trauma patient? A) Prevents aspiration and pneumonia B) Prevents hypoxemia and hypercarbia C) Prevents snoring respirations D) Prevents the tongue from blocking the pharynx Answer: B) Prevents hypoxemia and hypercarbia QUESTION Essential airway skills include manual clearing of the airway, manual maneuvers, suctioning and which of the following? A) Dual lumen airway B) Endotracheal intubation C) Laryngeal mask airway D) Oropharyngeal airway Answer: D) Oropharyngeal airway QUESTION Your patient is a middle aged male who crashed his motorcycle. He is unresponsive. After opening the airway using a modified jaw thrust, you note the patient has respirations at a rate of 6. Auscultation reveals breath sounds are absent on the left side. Which of the following is the most appropriate next intervention? A) Apply a non-rebreather mask B) Begin ventilation with a BVM C) Insert an endotracheal tube D) Perform a needle decompression Answer: B) Begin ventilation with a BVM QUESTION Which best describes shock? A) Decreased Glasgow Coma Scale (GCS) B) Flushed, dry, hot skin combined with bradycardia C) Generalized inadequate tissue perfusion D) Low blood pressure combined with tachycardia Answer: C) Generalized inadequate tissue perfusion QUESTION Your patient has a deep laceration to his antecubital fossa with significant bleeding. What is the most appropriate initial action? A) Apply a tourniquet B) Apply direct pressure C) Initiate rapid transport D) Restore blood volume Answer: B) Apply direct pressure QUESTION Which of the following is a key finding that differentiates cardiac tamponade from tension pneumothorax? A) Distended jugular veins B) Equal breath sounds C) Hypotension D) Tachycardia Answer: B) Equal breath sounds QUESTION Your patient is a 20 year old male who struck his head on a teammate's knee while diving to catch a football. He was not wearing a helmet. He demonstrates decerebrate posturing and has a GCS score of 4. His heart rate is 58, blood pressure 180/102 and his left pupil is dilated. What is the best ventilation rate to use when managing this patient? A) 10 breaths per minute. B) 20 breaths per minute. C) 30 breaths per minute. D) 35 breaths per minute. Answer: B) 20 breaths per minute QUESTION A 20 year old female was ejected from her vehicle during a high speed roll-over motor vehicle collision. She has significant bleeding from a large laceration. Your initial assessment reveals a GCS score of 7, systolic blood pressure of 70 mm Hg and pupils that are equal but respond sluggishly to light. After establishing two large bore IV lines, you should titrate the infusion rate to achieve a target blood pressure of at least A) 60 mm Hg. B) 70 mm Hg. C) 80 mm Hg. D) 90 mm Hg. Answer: D) 90 mm Hg. QUESTION Which of the following is the preferred prehospital wound management for a patient with a 36% body surface area flame burn? A) Cool moist dressings B) Dry sterile dressings C) Elastic bandages D) Topical ointments Answer: B) Dry sterile dressings QUESTION The most immediate life threatening condition resulting from injury to solid abdominal organs is which of the following? A) Acute respiratory failure B) Hemorrhage. C) Multiple organ failure. D) Peritonitis Answer: B) Hemorrhage. QUESTION An adult male sustained a deep laceration to his distal thigh. Bright red blood is spurting from the wound. Direct pressure is not controlling the bleeding. What is the most appropriate next step? A) Apply a topical hemostatic agent and transport B) Apply a tourniquet and tighten it until bleeding stops C) Elevate the leg and apply pressure to the femoral artery D) Maintain direct pressure and transport immediately Answer: B) Apply a tourniquet and tighten it until bleeding stops QUESTION An 18-year-old female was struck by a car and has sustained an apparent left femur fracture. Communication with her is hampered because she only speaks a foreign language. Which finding, by itself, does not mandate immobilization of the cervical spine? A) Fracture of the femur B) Inability to communicate C) Mechanism of injury D) Tenderness over the cervical spine Answer: C) Mechanism of injury QUESTION During the primary survey of a trauma patient, you note that the patient is agitated and confused, and has multiple injuries from an altercation. Which of the following choices is the most appropriate first treatment priority? A) Blood glucose determination B) Correction of possible hypoxia C) Full immobilization to a backboard D) Obtain intravenous access Answer: B) Correction of possible hypoxia QUESTION The displacement of tissue away from the path of a projectile, both temporarily and permanently, is known as: A. Conization B. Cavitation C. Golden era D. Golden minutes Answer: A. Golden period (hour) QUESTION In the absence of extenuating circumstances, the maximum amount of time it should take to identify and manage immediate threats to life, prepare the patient for transport and begin transport is _________? A. 5 minutes B. 10 minutes C. 15 minutes D. 30 minutes Answer: B. 10 minutes QUESTION In which of the following situations is the use of a short spinal immobilization device indicated? A. 28 year old male, unrestrained driver in a frontal impact crash. Awake, asks repeatedly what happened, complains of a headache, has a hematoma on his forehead. BP 122/84, HR 92, VR 20. B. 40 year old female who was pushed down a flight of stairs and is lying prone on the landing between two flights of stairs, complaining of back pain. BP 118/78, HR 100, VR 20. C. 17 year old female, restrained driver in a frontal impact crash. Awake, pale and diaphoretic, complains of upper right quadrant abdominal pain. BP 100/70, HR 108, VR 20. D. None of the above Answer: D. None of the above QUESTION Your patient is a 32 year old man, restrained driver of a vehicle that has been involved in a frontal impact with a concrete bridge abutment. The patient is awake, but has difficulty answering questions due to shortness of breath. His ventilatory rate is 30 per minute. Of the following choices, when is the first time the patient's breath sounds should be checked? A. As soon as he is removed from the vehicle B. Prior to being removed from the vehicle C. As soon as he is immobilized on a long backboard D. Enroute to the trauma center Answer: B. Prior to being removed from the vehicle